The relationship between the triglyceride-glucose index and functional outcomes in patients with aneurysmal
Yuyang Hou1, Xinyi Guo2, Hongkuan Yang1
1Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Road, Wuhan, 430030, Hubei, People's Republic of China.
Background:
Aneurysmal subarachnoid hemorrhage (aSAH) is a life-threatening disease with high morbidity and mortality. The triglyceride-glucose (TyG) index, a marker of insulin resistance (IR), has been linked to adverse outcomes in cerebrovascular conditions; however, its influence on functional prognosis in aSAH remains unclear. This study aimed to elucidate the relationship between the TyG index and functional outcomes in aSAH patients.
Methods:
A retrospective cohort study included consecutive aSAH patients. Functional outcomes were assessed using the modified Rankin Scale (mRS) at 3 months and categorized as favorable (mRS 0-2) or unfavorable (mRS 3-6). Univariate and multivariate logistic regression analyzed the association between the TyG index and functional outcomes. Propensity score matching (PSM) was used to mitigate confounding. Non-linear relationships were explored with restricted cubic splines (RCS), and subgroup analyses were performed. A nomogram integrating the TyG index and traditional prognostic scales was developed, and model predictive performance was compared using the area under the curve (AUC) on a test set.
Results:
A total of 470 patients (61.7% female) were enrolled, with 154 experiencing unfavorable outcomes. Multivariate logistic regression showed a significant association between the TyG index and adverse outcomes (OR: 1.86, 95% CI 1.12-3.1, P = 0.017). An optimal TyG index cutoff of 8.83 was identified. Patients with TyG index ≥ 8.83 had a higher risk of poor outcomes (48.7% vs. 24.8%; P = 0.015). PSM confirmed these findings. RCS indicated a progressive association between elevated TyG index and increased risk of adverse functional outcome. Subgroup analyses showed consistent relationships. The enhanced model with the TyG index had a higher AUC (0.899) than the traditional model (0.889, DeLong test P = 0.048).
Conclusions:
A high TyG index is significantly associated with an increased risk of unfavorable functional outcomes in patients with aSAH.
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